Active NPI
Elena Marie Eagan, C.R.C.
- Rehabilitation Counselor
- Concord, CA
National Provider Identifier
1972629681
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Counselor
- License
- 00052292
- Practice address
- 1420 Willow Pass Rd
Suite 140
Concord, CA 94520-5223 - Phone
- (925) 646-5775
- Fax
- (925) 646-5680
- NPI assigned
- Mar 22, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Counselor | 225C00000X | 00052292 | CA | Primary |
Addresses
Primary practice location
1420 Willow Pass Rd
Suite 140
Concord, CA 94520-5223
Mailing address
725 Parkway Dr
Martinez, CA 94553-3472
Phone (925) 228-0176
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00052292 | CA | MD | Rehabilitation Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1972629681",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "725 PARKWAY DR",
"city": "MARTINEZ",
"state": "CA",
"postal_code": "945533472",
"telephone_number": "925-228-0176",
"fax_number": "925-228-0989"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1420 WILLOW PASS RD",
"address_2": "SUITE 140",
"city": "CONCORD",
"state": "CA",
"postal_code": "945205223",
"telephone_number": "925-646-5775",
"fax_number": "925-646-5680"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EAGAN",
"first_name": "ELENA",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "C.R.C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225C00000X",
"taxonomy_group": "",
"desc": "Rehabilitation Counselor",
"state": "CA",
"license": "00052292",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Concord, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.